Healthcare Provider Details

I. General information

NPI: 1922921196
Provider Name (Legal Business Name): HOSPITALIST PHYSICIAN P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 FAY RD
SYRACUSE NY
13219-3009
US

IV. Provider business mailing address

103 BRANDYWINE DR
MANLIUS NY
13104-7953
US

V. Phone/Fax

Practice location:
  • Phone: 315-488-2951
  • Fax:
Mailing address:
  • Phone: 315-228-1162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAVI KUMAR REDDY GANGIREDDY
Title or Position: OWNER
Credential: MD
Phone: 315-228-1162